CIHM 
Microfiche 
Series 
(l\/lonographs) 


ICI\1H 

Collection  de 
microfiches 
(monographies) 


Canadian  Inttituta  (or  Historical  Micrcraproduction*  /  Inititut  Canadian  da  mlcroraproductions  tiiatoriquas 


©1996 


Technical  and  Bibliographic  Notes  /  Notes  technique  et  bibliographiques 


The  Institute  has  attempted  to  obtain  the  liest  original 
copy  available  for  filming.  Features  of  this  copy  which 
may  be  bibliographically  unique,  which  may  alter  any  of 
the  images  in  the  reproduction,  or  which  may 
significantly  change  the  usual  method  of  filming  are 
checked  below. 


D 

D 

n 

D 
D 
D 

D 

0 

D 

D 

D 


Coloured  covers  / 
Couvenure  de  couleur 

Covers  damaged  / 
Couverture  endommagde 

Covers  restored  and/or  laminated  / 
Couverture  restaur^  et/ou  pelllcuMe 

Cover  title  missing  /  Le  Utre  de  couveiluie  manque 

Coloured  maps  /  Cartes  geographiques  en  couleur 

Coloured  ink  (i.e.  other  than  blue  or  black)  / 
Encre  de  couleur  (i.e.  autre  que  bleue  ou  noire) 

Coloured  plates  and/or  lllustratkms  / 
Planches  et/ou  lllustrattons  en  couleur 

Bound  with  other  material  / 
Relie  avec  d'auties  documents 

Only  editkxi  available  / 
Seule  edltk)n  disponible 

Tight  binding  may  cause  shadows  or  distortion 
along  Interior  margin  /  La  reliure  serree  peut 
causer  de  I'ombre  ou  de  la  dlstorskin  le  long  de 
la  marge  interieure. 

Blank  leaves  added  during  restoiatkins  may  appear 
within  the  text.  Whenever  possible,  these  have 
been  omitled  from  timing  /  II  se  peut  que  certaines 
pages  blanches  ajouttes  kirs  d'une  restauration 
appaialssent  dans  le  texle,  mais,  kxsque  cela  etait 
possible,  ces  pages  n'ont  pas  ete  Hmees. 


L'Institut  a  microfilm^  le  meilleur  examplaire  qu'il  lui  a 
616  possible  de  se  procurer.  Les  details  de  cet  exam- 
plaire qui  sont  peut-6tre  uniques  du  point  de  vue  bibli- 
ographique,  qui  peuvent  modifier  une  image  reproduite, 
ou  qui  peuvent  exiger  une  modifications  dans  la  meth- 
ods nonnale  de  filmage  sont  indiqu^s  ci-dessous. 

I     I      Cotoured  pages  /  Pages  de  couleur 

I     I      Pages  damaged  /  Pages  endommag^es 

I     I      Pages  restored  and/or  laminated  / 
' — '      Pages  restaurfes  et/ou  peilkaii^es 

rp'     Pages  discoloured,  stained  or  foxed  / 
"^      Pages  Mcokxies,  tachettes  ou  piquees 

I     I      Pages  detached  /  Pages  ddtachees 

rTf     Showthrough  /  Transparence 

I     I      Quality  of  print  varies  / 

' — '      Quality  inigale  de  rimpresskm 

I     I      Includes  supplementary  material  / 
' — '      Comprend  du  materiel  suppMmentaire 

I  I  Pages  wholly  or  partially  obscured  by  errata 
' — '  slips,  tissues,  etc.,  have  been  refllmed  to 
ensure  the  best  possible  image  /  Les  pages 
totalement  ou  partiellement  obscurcies  par  un 
feuillet  d'errata,  une  pelure,  etc..  ont  6t6  filmees 
a  nouveau  de  fa(on  a  obtenir  la  mellleure 
Image  possible. 

I  I  Opposing  pages  with  varying  colouration  or 
' — '  discolourations  are  filmed  twk;e  to  ensure  the 
best  passible  image  /  Les  pages  s'opposant 
ayant  des  colorations  variables  ou  des  decol- 
orations sont  filmtes  deux  fois  afin  d'obtenir  la 
meilleur  image  possible. 


D 


Addttkxial  comments  / 
Convnentaires  euppMmentalres: 


This  item  it  nimad  at  th«  reduction  ratio  ctiKktd  below/ 

Ce  doctimfnt  tst  ftlmi  lu  tattx  dt  rWuetiOfl  indiqtit  et.d«nou«. 

10X  14X  tax 


2X 


»x 


XX 


u 

— 

J 

n 

12X 


20X 


28X 


Th«  copy  lllinad  har*  ha*  b««n  raproduead  thanka 
to  Iha  ganaroaity  of: 

D.B.  WtWon  Library 
Unlnriity  of  WMttm  Ontario 


Tha  Imagaa  appaaring  hara  ara  Iha  baat  quality 
ponlbia  considaring  tha  eondltton  and  laglbillty 
of  tha  original  copy  and  In  kaaping  with  tha 
filming  contract  apaeifieatlona. 


Original  eeplaa  In  printad  papar  covof*  ara  fllmad 
baglnning  with  tha  front  cover  and  anding  on 
tha  laat  paga  with  a  printad  or  illuatratad  impraa- 
alon,  or  tha  back  covar  whan  approprlata.  All 
othar  original  copiaa  ara  fllmad  baglnning  on  tha 
firat  paga  with  a  printad  or  Illuatratad  impraa- 
alon,  and  anding  on  tha  laat  paga  with  a  printad 
or  Illuatratad  improaaion. 


Tha  laat  raeordad  frama  on  aaeh  microficha 
ahall  contain  tha  aymbol  ••^  (moaning  "CON- 
TINUED"), or  tha  aymbol  ▼  (moaning  "END"), 
whiehovar  appiiaa. 

Mapa.  platac,  chart*,  ate.,  may  ba  fllmad  at 
djffarant  raduction  ratloa.  Tlioaa  too  larga  to  ba 
antlraly  ineludad  in  ona  axpoaura  ara  fllmad 
baglnning  in  tha  uppar  laft  hand  comar.  laft  to 
right  and  top  to  bottom,  aa  many  framaa  aa 
raquirad.  Tha  following  diagram*  Uluatrata  tin 
mathod: 


1  2  3 


1  2 

4  5 


L'mtmplair*  tUmt  fut  rapredult  grlei  i  !■ 
gtntrosM  d*: 

D.B.  WtMon  Library 
Unlnnity  of  Wm*m  Ontario 

Lm  imagai  luivantM  ont  ttt  raprodultM  avce  I* 
plu*  grind  loln.  eompta  Mnu  da  la  condition  at 
da  la  nottat*  da  I'axainplalra  film*,  at  an 
eonfomiM  avae  laa  cenditlona  du  contrat  da 
fllmaga. 

Laa  axamplairaa  orlglnaux  dont  la  couvartura  an 
paplar  aat  Imprlmto  aont  fllmto  an  commandant 
par  la  promlar  plat  at  an  tarminant  soit  par  la 
darnitra  paga  qui  eompotta  una  amprainta 
d'Impraaalon  eu  d'llluatratlon,  aolt  par  la  sacond 
plat,  aalon  la  eaa.  Toua  laa  autraa  axamplaira* 
orlglnaux  aont  fllmta  an  eomman^ant  par  la 
pramMra  paga  qui  comporta  una  amprainta 
d'Impraaalon  ou  d'llluatratlon  at  an  tarminant  par 
la  darhWra  paga  qui  comporta  una  talla 
amprainta. 

Un  daa  aymbolaa  aulvant*  apparattra  aur  la 
darnMra  Imaga  da  chaqua  microficha.  lalon  la 
cat:  la  aymbola  —»■  lignlfia  "A  SUIVRE",  la 
aymbola  V  aignKIa  "FIN  ". 

Laa  eartaa.  planchaa.  tablaaux.  ate.  pauvant  ttra 
fllmte  i  daa  taux  da  rMuetion  diffirantt. 
Loraqua  la  documant  aat  trap  grand  pour  ttra 
raproduit  an  un  aaul  elicM.  11  aat  film*  *  partir 
da  I'angla  auptriaur  gaucha.  da  gaucha  i  droita. 
at  da  haut  an  baa.  an  pranant  la  nombra 
d'imagaa  nteaaaaira.  Laa  diagrammaa  auivants 
llluatrant  la  mMhoda. 


2 

3 

5 

6 

MOlOCOrY   HSOLUTION   TBT  CHAtT 

(ANSI  bid  ISO  TEST  CHART  No.  3) 


1.0 


I.I 


II 


1.8 


IB  Ji^  1^ 


^     /IPPLIED  IIVHGtf    Ini 


(716)   M2-  QJOO-PHon. 
(716)  2BS-»e9  -fai 


li 


SKUVOIISNESS    IX    CHil-DHEX-lTS 
CAUSES  AND  I'HEVEN't'ION  • 

I'llAllLKS  K.  XkU,  M.T). 
INDIANAl'OLia 

Thoi-e  is  probably  not  iiiiother  term  in  tin' 
rnrini  of  svnnitoinnloloc.v  oscl  a:^  lr.,|m'..tlv  l,> 
the  sick  as  that  of  nervousness  in  attempting  to 
describe  their  feelings,  especially  wlien  sulTcring 
from  diseases  of  the  nervous  system,  whether  of 
so-called  functional  or  organic  basis.  It  is  also 
pretty  sate  to  say  that  there  is  not  another  term 
in  medical  literature  applied  to  as  many  diffcrcnl 
conditions.  This  being  the  ease,  it  naturallv 
follows  that  anv  attempt  to  describe  or  interpret 
it  as  a  tangible  specific  subject  meets  «ith  the 
relative  difflcnltv  cnconntered  in  one's  inability 
to  limit  its  application  to  a  specific  condition  or 
group  of  conditions. 

Again  and  again  an  attempt  has  been  ra.ide  to 
"licit  from  patients  enumcrat'ng  nervousness  i.s 
a  complaining  symptom,  definitely  and  specific- 
ally what  condition  or  nieuiii.g  it  was  desired  to 
convey,  with  the  almost  invariable  result  of  being 
informed  that  there  was  present  an  indescribable 
feeling  of  disinnir.irt  and  negative  fceling-tonc. 
frcouentlv  apart  In.m  and  in  additiim  to  any 
manifest' phvsicnl  or  mental  instability.  Xot 
only  is  it  difficult  to  define  just  what  is  meant  by 


•  Read   bpforp   tlio   Indlnn 
fiirtiniiapon»  SPMion.  ll'l-- 


Modicnl    .VBwnolniloii, 


^'-'l  '"flWfi-H*! 


nervousness,  but  it  is  also  just  as  diflicul 
the  line  between  what  may  be  termed  pi 
nr  normal  conditions  of  nervousness  at 
logic  or  abnormal  states.  On  tlie  other 
is  comparatively  easy  to  recognize  whc 
pleased  to  call  a  nervous  temperament 
vous  constitutional  make-up.  It  is  anot 
lion  entirely  to  describe  all  of  the  elem 
go  to  make  up  that  temperament  or  mo 
has  been  said  "that  when  an  individui 
endure  the  ordinary  difficulties  and  cone 
life,  or  the  natural  physiologic  functioi 
various  organs  of  the  body  without  ma 
untoward  distress  and  disturbance,  it  is  f 
there  must  be  some  natural  infirmity 
bility  of  the  nervous  system. 

The  essential  difference  between  the 
adult  and  the  neurotic  child  is  one  o 
modified  by  the  influence  of  numerous  ai 
expcricuoes,  as  well  as  of  a  more  matur 
and  phytical  devclopmen*.  The  child  b 
under  the  control  of  judgment,  reason, 
and  the  emotions,  will  react  more  prom 
definitely  in  relation  to  the  disturbing 
These  reactions  are  almost  wholly  out 
objective  manifestations,  whereas  in  the 
many  of  them  are  inward  or  subjective 
ances.  As  a  consequence,  the  neurotic 
characterized  physicaJy  by  evidence  of 
normal  nervou.,  balance,  signs  of  irregi 
vcus  action  in  the  various  movements  of 
musculature,  particularly  of  the  e.vtremil 
and  speech,  Meitally,  there  is  impair 
the  power  of  attention,  not  necessarily  an; 


iust  as  difficult  to  draw 
'  be  termed  phygiologic 
orvousness  and  patho- 
On  tfie  other  hand,  it 
•ecognize  what  wo  are 
cmperament  or  a  ner- 
p.  It  is  another  ques- 
1  of  tlie  elements  that 
rament  or  make-up.  It 

an  individual  cannot 
Ities  and  conditions  of 
logic  functions  of  the 
jf  without  manifesting 
irbance,  it  is  plain  that 
al  infirmity  or  i.-^ita- 
1. 

between  the  ncurotir 
"Id  is  one  of  degree 
E  numerous  and  varied 
1  more  mature  mental 

The  child  being  less 
ment,  reason,  volition 
jt  more  promptly  and 
TO  disturbing  factors. 
it  wholly  outward  or 
hereas  in  the  adult  bo 
or  subjective  disturb- 
the  neurotic  child  is 

evidence  of  want  of 
gns  of  irregular  ner- 
lovements  of  the  body 
f  the  extremities,  face 
;re  is  impairment  of 
lecessarily  any  lack  of 


intelligence,  but  more  partirulariy  a  defective, 
inefficient  power  of  control.  Obsessions  are  often 
a  marked  feature  in  neurotic  children,  their 
weaker  minds  being  more  apt  to  become  the  vic- 
tims of  predominating  or  overpowering  ideas. 
Moral  obliquities,  such  as  lying,  thieving,  etc.. 
are  also  common  in  such  children,  more  the  re- 
sult of  an  exuberant,  romantic,  riotous  imagina- 
tion than  of  any  direct  conscious  or  preformed 
reasoning  or  judgment. 

In  attempting  to  determine  and  analyze  the 
(ronditions  or  factors  which  are  instrumental  in 
laying  the  foimdation  of  a  temperament  or  con- 
stitutional make-up  of  this  nature,  it  will  be 
found  that  for  all  practical  purposes  they  may  be 
included  under  three  distinct  groups,  namely : 

1.  Hereditary  influences. 

2.  Nutritional  and  hygienic  conditions. 

3.  Educational  and  disciplinary  influences. 

We  c:nnot  with  any  degree  of  definiteness  ex- 
plain how  it  happens,  yet  at  the  same  time  it  can 
scarcely  be  doubted  that  every  individual  inherits 
in  his  .  r  her  substrata,  not  only  parental,  but  also 
ancestral  qualities  and  characteristics  of  physical 
and  mental  make-up,  which  are  ready  to  spring 
into  activitv  of  function  at  different  periods  of 
life,  'so  thai  the  qualities  of  one  ancestor  may 
come  into  existence  at  one  period,  and  those  of 
another  ancestor  become  evident  at  another 
period  of  the  individual's  life.  The  single  sperm 
cell,  integrating  the  qualities  of  generp^ions  of 
male  and  female  ancestors,  unites  wit',  the  germ 
cell,  which  in  like  manner  has  incorporated  the 
qualities  of  male  and  female  progenitors,  and 


tlii«  combinatJDii  givej  ri»c  to  u  ijpw  or 
duct,  wliich,  minute  ai  it  i«,  contain 
form  all  of  tiic  potentialities  and  a( 
|ila.v»  during  the  evolutionary  proce, 
the  characters  and  qualities  of  the  a 
both  sides,  anil  in  addition,  evinces  ni 
as  a  result  of  that  combination,  prope 
arc  uulilto  tlie  constituents  which  ci 
such  original  combination.  This  pi 
hereditary  transmission  ij  fvlly  recogr 
who  have  studieil  th-  subimt  throi 
whole  realm  of  creation,  not  only  in  t 
but  also  in  the  vegetable  kingdom.  T 
pie,  furthermore,  is  being  d«ily  put  t 
usefulness  in  the  production  and  devei 
a  better  and  more  highly  organized  proi 
various  phases  or  forms  c'  orgjnic  li 
man.  The  human  organism  is  subject  t 
organic  laws,  passes  through  the  same  I 
es  its  corresponding  part  ,u  the  ult 
of  the  creation.  It  may  differ  to  somt 
the  decree  or  form  of  ciiangc  and  in  tli 
quired  for  their  evolution,  but  the  essei 
nmental  principle  is  ;he  same. 

In  considering  the  question  of  the 
factor  or  faciors  transmitted,  it  is  cus 
speak  of  certain  predispositions,  ten< 
properties  in  the  make-up  of  the  i 
either  physical  or  psychical,  or  a  coir  o 
both,  as  the  hereditary  element.  Ihi 
sarily  vary  in  intensity  and  number, 
said  to  be  more  marked  in  the  transmiss 
maternal  than  of  the  pati^rna'.  Aaractei 
in  males  than  females,  and  more  in  t 


■ma^ 


»e  to  a  new  or^AnJc  prod- 
it  18,  contains  in  latent 
ilities  and  actually  din- 
ionary  procofs  many  nf 
ties  of  the  anepstorft  of 
on,  evinces  new  feature* 
nation,  properties  which 
nts  which  entered  intn 
on.  Tins  principle  in 
i  t\'.\)y  recognized  by  nil 
Bubiect  thi-ouj?ho«t"  the 
not  only  in  the  animal, 
kingdom.  This  princi- 
ij  dpily  pnt  to  practic..;' 
ton  and  development  of 
jrganizcd  product  in  the 
c'  orgmic  life  not  hu- 
im  is  subject  to  the  samf 
g'l  the  same  phases,  and 
irt  II.  the  ultimate  goal 
tlitrur  to  some  extent  in 
nge  and  in  the  time  re- 
,  but  the  essential  fund- 
lame. 

stion  of  the  hereditary 
;ted,  it  is  customary  to 
o;5itlon9,  tendencies  or 
up  of  the  individual, 
al,  or  a  con  oinaticn  of 
■lement.  Ihese  neces- 
and  number,  an  are 
the  transmission  ol'  the 
rnal  characters,  greater 
id  more  in  those  born 


nfttT  the  .i-..iiifcrtation  nf  ilctiniti'  diw)rders  tluni 
hi^fory  thei.  appearance. 

It  is  still  a  matter  of  controversy  whothur  or 
io  what  extent  Ho-cnlled  acquired  characters  ore 
transmitted,  yet  it  seems  reawmable  to  assume 
that  even  if  ni.  transmissible  they  at  !enst  excr- 
I  isi'  a  modifying  iiiHuence  either  directly  or 
indirectly  on  the  constitutional  make-up  of  the 
individual,  'i'his  fact  seems  to  be  fully  estiib- 
lished  when  one  conoid,  rs  the  injurious  « ITccts  on 
tile  otTspring  of  such  eruditions  as  oh '^holii'm. 
svph'lis,  tuberculosis  .".nd  so-called  funttionni 
types  of  nervous  and  mental  disturbances.  Von 
Ziehen  states  "that  after  heredity,  chronic  alco- 
holism is  the  most  important  factor  in  the  trans 
mission  of  neuropathic  and  )»Bychopathic  states." 
It  is  said  that  in  at  least  35  per  cent,  of  individ- 
uals afllicted  with  epilepsy  a  histor)-  of  alcoholism 
t  iin  be  obtained  in  one  <>r  both  parents.  In  1,000 
cases  of  mental  defectiveness  examined  by  Four- 
iiiev,  there  was  a  history  of  alcoholism  in  the 
father  in  471,  in  the  mother  in  eighty-four,  and 
in  both  parents  in  sixty-live.  It  is  also  n  ratlier 
common  observation  that  children  of  alcoholics 
manifest  lessened  vitality,  a  low  nervous  tone, 
weakened  vital  organs,  I'-ls  competent  to  resist 
ftpd  endure  disease  or  faiigue,  less  power  of 
rtL'upcration ;  are  almost  eertpin  to  manifest 
r.iore  or  'ess  incompt^tency  or  non-resistance,  and, 
as  a  consequence,  readilv  fall  victiiis  to  the 
strains,  temptation  and  unsanitary  conditions  of 
life.  As  regards  syphilis,  no  less  an  puthority 
than  Ziehen  has  found  positive  indications  of 
syphilis  in  10  per  cent.,  and  probable  syphilis  in 


I 


1>  per  wnl.  „f  „,.,,„,|  ,|^,„,,| 
■"  o,„,  ,t  ,„„v  |„  ,„j,,  ^  ^ 

.lyl.o.m,yehil,lr..„„,,i„„;'i? 
1'™  "'«'-'•-'»«<■,•,„„„„  higher 

'mirtionnl  „..„„„,  ,li,,urba„ro   tl 

'"■i-'d.tyi.  i„,Ik.aMb.vtl.ofa.tt 
"■"••  "f  "l-il-l'-i™  a  hi.tory  of  ™i,, 

'tyi.tr.™,,l,|.„Mlm  ,„««,-,„  ore 

fhircl  on.l  both  in  one-tenth 

Improper  food,  ,ome  becoming 
o  her.  „verfe,l,  „,he™  „„,uitablv\ 
oacmUwene,  never  siverUe -to. 
i'<l  of  pl,js,oa|  or  mental  devclopmc 
"  °  ™"»™"ence,  are  unable  to  res'.! 
'lure  ,ell  tho.e  conditions  which  „p 

ha    on  the  method,  of  feeding  and 
tots  during  the  early  „.^e8  of  e.i.t, 

fact  the  atrength  and  physique  of 
One   „  almoat  justified   in   assertin, 
■oath  and  physique  of  the  nation; 
asthef«Kl  supply  during  infancy  and, 
'"»<I.'    InsniBcient  and  improper  /, 

fnstSr"';  '"■"'■"'i™.  «nt  of  eon, 
instabihty,  irntability  and  other  cvi 
imperfect  and  retarded  cerebral  dcvelo] 


^-^^aagrfit  I 


M  ;W..H,u,.  A.  to  ,„b„f. 
"'  ''»'  "I"''!  evnn  in  mon- 
'  »  '""'"'■y  "'  lubomil,,,!,  i. 

"'i:'-.  ypl  in  mi'iiui  tlofiT 
'  I'"'-}'  '''kI'".  vorying  from 

to  ofl  per  cent.  (Kolioz). 
»«  on  c.vunipic  ol  so  o  "".l 
"tlirlianro,  tlic  influtn  3/ 
'»■  tlio  fact  that  in  36  per 
i«l"ry  of  cpilcp,y  or  i„,„„. 
"""■"'""  "■■  '■ollatcral  roln- 
■ily  histor)-  of  cpilepjy  i„ 
>M  caw,,  i„„„i,y  j„  „„„. 
-tenth. 

'"  IwMniing  half-gfarved, 
unnuitably  fed,  improper 

Sive  rise  to  a  good  ,tand- 
l«l  development,  and  «ucl. 
■able  to  rc.-.t  long  or  en- 
1"  which  sap  the  vigor  or 

the  test  comes.     Canlley 

t:.o  shadow  of  n  douli't 

feeding  and  rearing  in- 
■ages  of  esistence  depend 

of  the  children,  and  in 
Pli/sique  of  the  nation. 

in  asserting  that  the 
he  nation  varies  directly 

infancy  and  early  child'- 

improper  food  means 
'Wth,  imperfect  physical 

want  of  concentration, 
nd  other  evidences  of 
rebral  development.   If 


not  octually  more  prone  to  contract  dise.w,  thev 
''  "ndoubtedly  more  prone  In  snffer  seve-  ' 
'    ..-n  sickness  does  ovcrloke  them.     Just  «■   it 

said  that  a  sound  body  makes  for  a  sound    ' 

«>  It  IS  true  that  a  feehlc  body  i,  often  the  ,.«. 
«-.or  of  „  fo,|,|„  „,i,„|  ,„-„„„„|,|„  „^^;,,^^^ 
mental  make-up. 

Proper  and  sumcicnt  rc.t  and  sleep  for  ll„. 
.voung  child  is  only  sccorul  „,  import.nee  to  that 
o  good  and  proper  f,«d.  Hegularity  in  the  hour, 
"f  sleeping,  feeding  and  awake  infuses  a  sens,,  of 
order  *li,ch  remains  with  th.ni  throughout  life 
"an  of  fresh  nir  and  sunshine,  exposure  In 
i-xtr  e.  of  heat  or  cold,  insanitary  dwellings  and 
'"r  adiiigs  often  lay  the  foundotion  for  Ihc 
future  instability  and  susceptibility  of  th"  ncr 
vous  .,,1  mental  make-up  of  an  individual.  Jlad 
mt,  for  example,  may  cause  0  great  deal  of 
barm  to  n  child,  evr  'hough  tho  eyesigut  b.. 
^'ood.  Often  theel,,  eems  stupid  and  slor 
nervous,  cross  and  irr  Ic,  when  i„  reality  the 
condition  is  due  to  the  strain  of  tired  eyes  and 
the  continued  straining  of  the  eyes  must  lie  a 
stroin  on  the  nervous  system.  These  induce  a 
more  or  less  morbid  restlessness,  both  mentnllv 
nnd  physically,  whi.li  eventually  results  in  ail 
enfecblement  ol  will  and  mental  power  which 
renders  ineffectual  the  means  employed  to  correct 
evils  resulting  therefrom. 

The  presence  of  physiial  defects  or  diseased 
conditions  are  very  often  responsible  for  abnor- 
mal nervous  manifestations.  Defective  and  bad 
teeth  interfere  with  the  proper  mastication  of  the 
food,  and  this  in  turn  leads  to  digestive  disturb- 


aiices  and  malnutrition,  or  to  tlie  , 

septic  products  from  an  unclean  o 

injurious  products  of  (lie  impaired  d 

ess.    Obstructions  in  tlie  nasal  cav 

in  or  catarrlial  conditions  of  tlie  na 

cavity,  or  enlarged  tonsils  interfere  w 

CSS  of  rcspimfio,,,  lead  to  deafness,™ 

iiig  and  all  tlic  conditions  that  may 

pernicious  habit.     Defective  hearins 

ent,  often  makes  the  child  seem  dul' 

iniittcntive  and  irritable,  and  niani 

nervous  and  mental  deficiencies  or  ab 

lisual   defects  likcwi.se   produce  a   i 

turbanccs,  greatly  interfering  with 

liinctioning  of  the  nervous  and  meiil, 

iloTOvcr  great  and  strong  may  be 

lary  tendencies  or  predisposition^,  for 

nil  are  whal  are  transmitted,  these 

important  or  powerful  in  the  evolution 

opment  of  the  organism  that  comes  inl 

as  are  appropriate  and  judicious  nurt 

tion  and  training,  wliidi  can  also  m. 

modity  and  neutralize  many  defects 

"esses  dependent  on  a  bad  licreditv     1 

tnil.v  said  (hat  the  lime  of  aost  vi'tal  i 

m  a  human  being's  life  is  from  birth 

.ip  of  two  to  three  years.     The  mos 

'haracteristic  of  the  new-born  child  is 

paredness  for  life.     The  brain  center- 

pitiable  state  of  undevclopment.  Its  sn, 

lessness  at  birth,  its  long  period  of  d, 

on  outside  aid  is  rich  in  biologic  and 

«.gniflean,.c.      It   presuppose,   a   spcci, 


«*'-!!!( 


II,  or  to  the  absorption  of 
nn  unclean  oral  cavity  or 
le  impaireil  digestive  proc- 
'"•'  nsMl  Mvity,  adenoids 
ins  of  tlie  nasophaiynfieal 
ils  interfere  with  the  pioc- 

0  deafness,  moutli-breath- 
ons  tlint  may  follow  that 
rtive  hearing,  when  pres- 
lild  seem  dull,  backward, 
'c,  and  manifest  various 
ciencrcs  or  abnormalities. 

prodnee  a  riilc  of  dis- 
fering  with  the  normal 
ins  and  mental  activities, 
ron,!;  may  be  the  heredi- 
ipositions,  for  such  after 
"tted,  these  are  not  as 

tlio  evolution  and  devel- 
.hat  conies  into  existence 
udicious  nurture,  educa- 

1  can  also  more  or  less 
lany  defects  and  wcak- 
tl  heredity.  It  has  been 
f  most  vital  importance 
is  from  birth  until  the 
rs.  The  most  strikiii}; 
liorn  child  is  its  unpre- 
brain  centers  are  in  a 
iment.  Its  special  liclp^ 

■  period  of  dependence 
biologic  and  sociologic 
OSes  a  specially  high 


development  of  the  protective  and  fostering  care 
of  the  parent. 

Injudicious  education  and  training  alone  may 
not  only  aggravate  or  intensify  an  inherent  mis- 
chief, but  may  also  give  rise  to  an  individual  sus- 
ceptibility or  predisposition  to  nervous  or  mental 
derangements.  Parents  not  only  transmit  the 
laints  and  vices  of  Nature,  but  too  often  foster 
their  growth  and  ilevelopmcnt  by  bad  example, 
by  foolish  training  when  the  mind  is  very,  if  not 
the  ninet  susceptible,  and  a  direction  given  to 
actions  and  conduct  decisive  for  life.  Parental 
harshness  and  neglect,  repression  of  the  child's 
natural  feelings,  stifling  its  natural  desire  tor 
love  and  affection,  thus  tending  to  drive  it  to  a 
morbid  self-brooding,  or  compelling  it  to  seek 
solace  in  a  world  of  weird,  vague  and  unhealthy 
fancies.  Foolish  indulgence,  from  which  it  never 
learns  the  lesson  of  self-control  or  of  respect  for 
or  recognition  of  the  rights  of  others  is,  on  the 
other  hand,  just  as  injurious  as  the  former  con- 
ditions. 

Parental  affection  may  be  well  founded,  but 
too  often  the  parental  responsibility  seems  to 
begin  and  end  with  silly  indulgence  of  the  child. 
Often  artificially  fed,  then  pampered  and  spoiled, 
it  grows  without  discipline  to  its  desires,  without 
a  knowledge  of  the  relations  to  tho.se  about  it, 
and  thus  handicapped,  it  becomes  domineering, 
resenting  any  interference  which  may  oppose  its 
desires,  and  overbearing  on  the  one  hand,  or 
indolent,  dissipating  and  intemperate  in  the 
habits  of  life  on  the  other  hand.  There  is  a  vast 
ditTcrence  between  tlic  individual  who  lias  been 


10 

schcK)]ed  to  meet  some  of  the  hardi 
.■ulties  of  life,  and  the  individual 
weakened  by  protection,  whose  ner 
have  been  heightened  by  education 
the  one  apparently  recovering  fron 
11  a  few  months,  the  other  often 
many  years. 

The  natural  pride   of  some   pa 

accomplishments  of  their  ehildre,, 

them  toward  educational  and  othei 

far  beyond  their  capabilities,  and 

collapse   follows,   from   which   the 

never  recover,  and,  while  not  dep 

value  of  higher  education  for  thos. 

every  way  lit,  it  is  safe  to  say  th< 

gained  at  the  expense  of  an  overwo, 

and  mental  organization  is  cortainl 

vestment  in  life's  securities.    There 

that  such  morbid  tendencies  could  b, 

or  rendered  harmless  by  directing  fh 

along  healthier  channels  by  the  infiu, 

education  and  sound  training      Cli 

that  a  defective  education  that  omi 

and  the  cultivation  of  self-control    t 

ting  the  child  for  the  nide  shocks  of 

a  predisposing  cause  of  neurasthenia 

Cramming  to  meet  the  various  « 

and  tests  tend  to  make  m..re  machi, 
children,  to  impair  their  ability  tn 
produce  instability  and  irritability  of 
and  mental  activities.  The  evil  inflm 
overtaxation  and  strain  is  often  seen 
dency  of  many  children  to  act  queei 
appear  from  home  or  to  run  aivay  f, 


10 

B  of  the  hardships  and  diffi- 
ic  individual  wlio  has  been 
)n,  whose  nervous  reactions 
by  education  and  training; 
covering  from  a  breakdown' 
e  other  often  requiring  a« 

of  some  parents   in   the 
heir  children  often  urges 
nal  and  other  attainments 
ibilities,  and,  as  a  result, 
n    whlcil    they    practically 
hile  not  depreciating  the 
tion  for  those  who  arc  in 
fe  to  say  that  n  diploma 
of  an  overworked  physical 
in  is  certainly  a  poor  in- 
'ities.    There  is  no  doubt 
ncies  could  be  neutralized 
f  directing  their  activities 
'  by  the  influence  of  good 
:raining.     Church  writes 
lion  that  omits  discipline 
self-control,  thus  illy  flt- 
ide  shocks  of  life,  mkv  he 

neurasthenia." 
he  various  examinations 

m"re  machines  of  some 
ir  ability  to  reason,  to 
rritability  of  the  nervous 
'he  evil  influence  of  this 
is  often  seen  in  the  ten- 

to  act  queerly,  to  dis- 
'  "■""  "My  from  school 


toward  the  dose  of  various  school  terms,  such 
manifestations  more  frequently  occurring  in 
children  having  a  neurotic  family  history. 

Morbid  sexual  desires,  instincts  and  habits  are 
often  generated  by  pernicious  methods  utilized 
by  girl  nurses  in  their  efforts  to  quiet  the  rest- 
lessness and  discomfort  of  ome  children,  and 
such  habits  eventually  lead  to  grave  mental  and 
moral  delinquencies. 

The  psychological  influence  of  those  about 
them  is  often  responsible  for  the  nervous  rest- 
lessness and  waywardness  characteristic  of  many 
children.  Tiierc  is  still  another  question  of  a 
sociologic  and  economic  nature  which  bears  a 
more  or  less  direct  relationship  to  and  influence 
on  not  only  the  development,  but  also  the  resist- 
once  and  vitality  of  the  organism.  It  has  been 
fully  demonstrated  in  other  forms  of  animal  life 
that  the  size  of  the  offspring  can  be  directly 
influenced  by  the  cheractcr  of  the  diet  and  state 
of  nutrition  of  the  mother,  and  if  this  be  true  of 
other  forms  of  animal  life  it  must  also  be  true 
of  human  life.  Furthermore,  it  cannot  be  other- 
wise than  that  where  during  the  pregnant  state 
or  even  while  nursing  her  offspring  the  mother 
is  subjected  to  unwholesome  nutrition,  unhealthy 
environment,  overwork  physically,  worry  or  exces- 
sive strain  mentally,  has  her  system  saturated 
Avith  poisons  introduced  from  without  or  arising 
from  diseased  processes  within  the  body,  must 
lower  the  vitality  and  vigor  of  the  offspring. 

Another  feature  is  found  in  the  social  condi- 
tion which  objects  to  and  interferes  with  the 
state    of    motherhood.      Selfish    motives,    extra 


hX 


12 

I'sptnses,  icstriitioii  of  liberty,  aJd 
responsibilities  incid-nt  to  the  can 
"f  children,  desire  to  wait  until 
I'onditions  are  reached,  means  uti 
vent  motherhood,  one  and  all  euust 
Miirrv  and  strain  that  is  so  nerve 
dread-inspiring  that  ninny  previ< 
mentally,  phvsieally  and  'mor.-.lly, 
stable  and  hysterical,  neitlier  fit  for 
motherhood.  When  such  arc  compel 
the  presnant  slate  to  run  its  eour.si 
accept  the  situation  ))hilo.sophicalli 
the  duties  and  functions  of  moth 
factorily.  Under  such  conditions 
instinct  cannot  he  expected  to  overc 
deficiencies  of  education  and  prepar 
Iicrformnnce  of  that  function.  Slati 
cannot  recover  the  energy  spent 
auRiiish,  nor  is  it  probable  that  the 
of  the  offspring  is  not  influenced  1 
dittons. 

From  all  of  these  considerations 
sions  may  be  offered  as  dealing  wi 
culties  to  be  overcome.  First,  we 
that  the  unborn  child  is  entitled  to  c( 
It  has  the  right  to  life.  It  has  the 
tection  from  hcrcditarv-  taints  of  def 
lias  the  right  to  health  and  those  c 
life  conducive  to  health.  It  has  i 
Xature's  food,  which  is  mother's  mi 
in  its  normal,  healthy  condition.  It  1 
to  natural  protection,  proper  care 
education  and  training.  These  righ 
mitted,  they  demand  the  reeognitioi 


12 

f  liberty,  added  duties  and 
tit  to  the  care  and  rearing 
I  wait  until  more  suitable 
d.  means  utilized  to  pre- 
and  all  euusp  more  or  loss 
t  is  so  nerve- wast in{^  and 
ninny  previously  healthy 
and  mor.illy,  become  un- 
leitlior  fit  for  wifehood  nor 
eh  arc  compelled  to  permit 
run  its  course,  they  rarolv 
)hilosophically  or  perform 
ions  of  motherhood  satis- 
1  conditions  the  .  utornnl 
icted  to  overcome  inherent 
m  and  preparation  for  tlie 
nction.  Slaternal  instinct 
iicrgy  spent  in  fear  and 
able  that  the  development 
t  influcnrod  by  such  con- 

msidcratious  some  conclu- 
fis  doalinjj  Avith  the  diffi- 
.  First,  we  must  admit 
1  entitled  to  certain  rights. 
.  It  has  the  rif^ht  to  pro- 
taints  of  degeneracy.  It 
I  and  those  conditions  of 
th.  It  has  the  right  to 
i  mothers  milk,  with  this 
ondition.  It  has  the  right 
proper  care  and  proper 
These  rights  being  ad- 
lie  recognition  of  certain 


I.! 


ilutiepi  mill  ohligHtintis,  iitiiDiigsi  which  may  he 
mentioned  n  clean  and  normal  life  on  the  part  of 
both  parents,  both  before  and  after  conception; 
constant  su})crvisi<in  iind  regulation  of  the  mode 
of  life  of  the  mother,  particularly  during  preg- 
nancy and  after  birth ;  proper  care,  feeding,  edu- 
cation and  training  after  birth,  for  if  born 
healthy,  babies  can  generally  be  brought  up 
healthy  by  clean,  sensible  feeding  and  by  reason- 
able attention  to  the  hygiene  and  sanitary  con- 
ditions surrounding  it  and  by  proper  training  of 
its  mental  and  intellectual  faculties.  A  promi- 
nent authority  has  said  "that  it  is  to  the  con- 
dition of  the  women  and  children,  mentally, 
morally  and  physically,  that  we  must  look  if  we 
have  regard  for  the  future  of  our  land."  These 
can  be  improved  by  better  education  of  the 
mothers,  by  the  creation  of  more  favorable  con- 
ditions of  life,  and  by  the  prevention  and  cor- 
rection of  physical  defects  and  faulty  tendencies 
during  the  early  period  of  growth  and  develop- 
ment, for,  as  Goodhart  writes,  "It  is  in  childhood, 
if  at  any  time  of  life,  that  the  opportunity  offers 
of  educating  the  individual  out  of  faulty  habits 
into  a  better  regulated  state  of  his  nervous 
system." 

While  tlie  solution  of  the  problem  involve 
soeiologic,  economical,  educational  and  discipli-: 
ai .  ditKculties,  yet  paramount  to  them  stanri- 
medical  supervision  and  direction.  Consequently, 
on  us  as  physicians  lies  the  responsibility  and 
rests  the  duty  of  advising  and  assisting  to  insti- 
tute those  measures  looking  to  their  solution.  It 
is  a  duty  encumbent  on  the  medical  profession. 


14 

and  one  that  they  owe  to  hunuiuity 

not  shirk,  to  educate  those  who  are'  i 

the   rearing   and   training  of  child 

should  endeavor  as  far  as  possible  to 

such  information  as  will  create  a  he« 

opinion  which  will  not  only  aim  to  cc 

ing  evils,  but  will  also  seek  to  preven 

duction  by  restricting  procreation  to 

preventing  procreation  by  the  unfit. 

true  that  too  often  but  little  attcntio 

and  much  medical  advice  is  wasted 

ignorance,  carelessness,  indifference  o 

neglect  of  those  to  whom  it  is  given, 

no  excuse  why  they  should  waver  in  th 

ante  of  their  duty  to  their  fellow-crea 

often  this  lack  of  influence  of  medi 

given  is  due  to  the  lower  moral  stand 

physicians   themselves,   for  one   couL 

expect  advice  of  this  character  to  have 

fluence  if  given  by  those  who  have  beei 

to  any  interference  with  Nature's  laws 

to  inculcate  higher  standards  of  moi 

Public  opinion  it  is  necessary  for  the  mi 

fession  as  a  whole  to  themselves  mail 

higher  standard. 

Assuming  a  child  to  be  healthy  and 
be  properly  fed  and  clothed,  to  have  i 
its  school  course  proper  games  and  gj 
there  is  no  reason  why  study  should  im 
health,  either  physically  or  mentally,  il 
supervised  and  directed.  Constant  br 
with  very  little  eierciee,  with  insufficie 
proper  food,  with  faulty  positions,  att 
habits,  with  uncorrected  physical  defe 


! 'Ui!  rt*:it,.^ 


14 

to  huiimnity  and  should 
Me  who  are  in  charge  of 
ing  of  children.     They 
18  possible  to  promulgate 
I  crente  a  healthy  public 
'nly  aim  to  correct  exiBt- 
eek  to  prevent  their  pro- 
rocreation  to  the  fit  and 
y  the  imfit.    While  it  is 
little  attention  is  given, 
pe  is  wasted  because  of 
indifference  or  c!    iinal 
1  it  is  given,  yet  that  is 
d  waver  in  the  perform- 
'ir  fellow-creature.    Too 
ence  of  medical  advice 
•  moral  standard  of  the 
'or  one   could   scarcely 
racier  to  have  much  in- 
fvho  have  been  accessori- 
Nature's  laws.  In  order 
Jards  of  morality  into 
ary  for  the  medical  pro- 
jmselves  maintain  that 

healthy  and  robust,  to 
led,  to  have  as  part  of 
James  and  gymnastics. 
dy  should  impair  their 
r  mentally,  if  properly 

Constant  brain  work 
Hth  insuflScient  or  im- 
positions, attitudes  or 
physical  defects,  with 


15 


unhygienic  f^urronndings.  will  tend  to  impair  or 
destroy  the  strongest  constitution.  Long  hourw 
of  study  without  recreation  interspersed  is  a 
trying  thing  for  children  to  do,  as  they  are  prob- 
ably much  more  diverse  in  their  ways  of  think- 
ing than  our  theories  supposvS  Certainly  there  in 
great  risk  in  overloading  the  memory  of  the  child 
with  little  details  and  impairinti  the  development 
of  the  mental  powers.  The  mcr'tal  training  of 
childhood,  youth  and  early  puberty  is  a  question 
of  paramount  importance,  as  it  calls  for  an  edu- 
cation for  the  daily  increasing  requirements  and 
competitions  of  modern  life,  which  are  appar- 
ently reaching  higher  and  higher  standards.  One 
cannot  fail  to  frequently  observe  the  great  dis- 
crepany  manifested  between  the  views  of  some 
doctrinaires  of  education  and  the  views  of  those 
who  have  practical  knowledge  of  the  laws  of 
Xature,  and  too  often  the  demands  and  exactions 
of  the  educationalist,  aided  by  the  over-indulgent 
and  aspiring  home  influences,  determine  and  f  >- 
duce  lasting  etfecta  in  the  lowering  of  the  viti.  y 
and  resistance  of  the  young  child. 

To  sum  up,  it  may  be  said  that  the  solution  of 
this  prfblem  can  never  be  reached  by  the  sociolo- 
gist alone,  or  by  the  economist,  or  by  the  educa- 
tionalist, or  by  the  disciplinarian,  or  even  by  the 
physician.  We  can  only  hope  to  attain  the  desired 
goal  by  the  closest  cooperation  of  all.  The  soci- 
ologist must  seek  constantly  to  improve  the  social 
and  moral  conditions  of  life ;  the  economist  to 
determine  ways  and  means  to  alleviate  the 
intense  struggle  for  existence;  the  educationalist 
to  better  understand  and  direct  the  intellectual 


.^v. 


16 


capabilities;  the  (IJKc-ipliiiaridii  tn  Ingtitt  m>lf- 
revercnce,  self-knowledge  nnd  wlf-control,  and 
iho  physician  to  sii|>or\iBc  rikI  direct  all  mieli 
measures  is  will  1m;  most  conducive  to  the  devel- 
fipmeiit  ot'  n  lu'nlliiy  biidy  and  mind. 

An  analysis  of  the  Rituation  flisclosea  the  fact 
that  an  iinniensc  amount  of  money  and  a  great 
4lca  of  enerjry  is  I)ciiig  spent  in  caring  for  the 
nervously  unfit  individuals  throughout  the 
i-ou  itry  wlio  are  lendored  incapable  of  caring  for 
then  Pelves  iideqiMtcly,  and  while  this  is  human- 
itarian and  abwplutely  necessary  from  every 
standpoifit,  yet  if  the  same  amount  of  money 
and  the  .'=am<'  amount  of  energy  were  spent  in 
determiniii  moans  and  nieaisurcs  to  jtrevent  the 
prodnttior  .»f  these  beings  and  to  give  them 
appropriate  rearing,  education  and  training  after 
their  creation,  a  great  deal  more  good  would  un- 
doubtedly be  accomplished.  ISefore  radical  meas- 
ures can  be  carried  out,  liowever,  the  people  must 
be  educated  to  recognize  its  usefulness  and  neces- 
sity, and  the  responsibility  of  this  educational 
propaganda  devolves  almost  -vholly  on  us  as 
physicians. 


